Microcystic adnexal carcinoma simulating scarring alopecia

Abstract

The microcystic adnexal carcinoma is a rare, locally aggressive malignant adnexal neoplasm associated with significant morbidity. It is often underdiagnosed due to clinical and histopathological resemblance with other cutaneous neoplasms and/or a combination of lack of familiarity associated with inadequate samples. We report a case with clinical hypothesis of scarring alopecia and histopathological diagnosis of microcystic adnexal carcinoma with favorable outcome in a follow-up of eleven years, after surgical treatment.

FIGURE 1

Hardened plaque with smooth and shiny surface, without hairs, measuring 5 cm in diameter located in the occipital region

FIGURE 2

Nodular aggregates and epithelial cell cords associated with corneal microcysts in the most superfi cial dermis. H&E 100X

FIGURE 3

Cell aggregates and epithelial cords, surrounded by dense fi brous stroma, infi ltrating the deep dermis and subcutaneous cell tissue. Observe the absence of pilosebaceous units. H&E 40X

FIGURE 4

Infi ltrative pattern, dense fi brous stroma and absence of nuclear pleomorphism. Observe the syringomatoid aspect, hence the synonymy “syringomatous carcinoma” H&E 100X